Self-retaining muscle retractor

ABSTRACT

A self-retaining muscle retractor including a pair of elongated members formed on their respective one extremities with boneengaging portions and on their respective opposite extremities with lever arms. One of the lever arms has one end of a rigid brace pivotally connected thereto and the free end of such brace is engageable with a latching element included on the other lever arm whereby the bone-engaging portions may be inserted in an incision and engaged on opposite sides of a bone, the lever arms spread apart to retract the muscles away from such bone and the free end of the brace engaged with the latching element to maintain the incision open for convenient access to the bone.

United States Patent 1 Halloran [54] SELF-RETAINING MUSCLE RETRACTOR [76] Inventor: William X. Halloran, 440 Fair Drive, Costa Messa, Calif. 92626 [63] Continuation-impart of Ser. No. 773,750, Nov. 6,

1968, abandoned.

[52] U.S. Cl ..128/20, 128/345 [51] Int. Cl. ..A6lb 17/02, A6lm 29/00 [58] Field of Search ..l28/003, 020, 345

[56] References Cited UNITED STATES PATENTS 2,695,607 11/1954 Hipps et al. ..128/O20 FOREIGN PATENTS 0R APPLICATIONS 59,995 7/1942 Denmark 1 28/003 51 May 8, 1973 OTHER PUBLICATIONS Girard, P. M. A Self-Retaining Retractor Useful In Open Operations On Bone," In Jour. Bone and Joint Surg. 1934, p. 612.

Primary ExaminerChanning L Pace AttorneyFulwider, Patton, Rieber, Lee & Utecht I 57 ABSTRACT A self-retaining muscle retractor including a pair of elongated members formed on their respective one extremities with bone-engaging portions and on their respective opposite extremities with lever arms. One of the lever arms has one end of a rigid brace pivotally connected thereto and the free end of such brace is engageable with a latching element included on the other lever arm whereby the bone-engaging portions may be inserted in an incision and engaged on opposite sides of a bone, the lever arms spread apart to retract the muscles away from such bone and the free end of the brace engaged with the latching element to maintain the incision open for convenient access to the bone.

12 Claims, 9 Drawing Figures PATENTED W 1973 SHEET 1 OF 2 F l G 2 INVENTOR. WILL/AM X. HALLORAN BY My Arron/vars FIG. l%

PATENT-ED 3.731.673

' sum 2 OF 2 I N VENTOR.

ML 4 MM )6 I144 L GPA/V BY? J SELF-RETAINING MUSCLE RETRACTOR CROSS REFERENCE TO RELATED APPLICATION This application is a continuation-in-part of U.S. Ser. No. 773,750 filed Nov. 6, 1968 and now abandoned.

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates generally to muscle retractors for maintaining an incision open for convenient access to a bone. 4 2. Description of the Prior Art Muscle retractors have been proposed which include a pair of arms having interconnecting ends whereby the arms may be inserted in an incision, extended along opposite sides of a bone, then spread apart and interconnected underneath the bone to hold such arms spaced apart and the incision open. A retractor of this type is disclosed in US. Pat. No. 2,695,607. Muscle retractors of this type suffer the disadvantage of necessitating stripping flesh from the underside of the bone for receipt of the interconnecting arms thus increasing the amount of surgical work required and prolonging the operating time.

SUMMARY OF THE INVENTION The present invention is characterized by a pair of elongated retractor members formed on their lower ends with bone-engaging portions and having their upper extremities defining lever arms. A brace is pivotally connected on one end to the upper extremity of one of the lever arms and has its free end engageable with latching elements on the other lever arm whereby the bone-engaging portions may be inserted in an incision, engaged on opposite sides of a bone, the lever arms spaced apart and the free end of the brace en gaged with a latching element to maintain the incision open for convenient access to the bone.

An object of the present invention is to provide a self-retaining muscle retractor which eliminates the necessity of stripping the bone around its entire periphery thus enabling use in the hip area and other areas where the underside of the bone cannot be readily stripped.

Other objects and advantages of the present invention will be made apparent from the consideration of the following description when taken in conjunction with the accompanying drawing.

DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of one arm member included in a self-retaining muscle retractor embodying the present invention;

FIG. 2 is a transverse sectional view of a patients thigh having a self-retaining muscle retractor embodying the present invention being utilized to hold an incision open;

FIG. 3 is a top view, in reduced scale, of the selfretaining muscle retractor shown in FIG. 2;

FIG. 4 is a partial perspective view of a second embodiment of the self-retaining muscle retractor of present invention;

FIG. 5 is a partial perspective view of a modification of the self-retaining muscle retractor shown in FIG. 2;

FIG. 6 is a perspective view of a second embodiment of the self-retaining muscle retractor of present invention;

FIG. 7 is a vertical sectional view taken along the line 77 of FIG. 6 and partially broken away;

FIG. 8 is a detailed view, in enlarged scale, of a portion of the muscle retractor shown in FIG. 6; and

FIG. 9 is a detailed view, in enlarged scale, of another portion of the muscle retractor shown in FIG. 6.

DESCRIPTION OF THE PREFERRED EMBODIMENTS The self-retaining muscle retractor shown in FIGS. 1, 2 and 3 includes arm members A and B formed with bone-engaging tabs 11 and 13 on their lower ends and having their upper extremities in the form of respective lever arms 15 and 17. Connected to the upper end of the lever arm 15 is a rigid bail type brace, generally designated 21 which has its free end 23 engageable with serrations 25 included in the lever arm 17. Thus, the retractor may be utilized by inserting the bone-engaging portions 11 and 13 into an incision 29 and on opposite sides of a bone 31, the arms 15 and 17 then spread apart to retract the muscles away from such bone and to enable the free end 23 of the brace 21 to be engaged with a selected one of the serrations 25 to maintain such arms A and B spaced apart and the incision 29 open for convenient access to the bone 31.

The tabs 11 and 13 are curved downwardly and inwardly for complemental engagement with the arcuatein-cross section bone 31. Included above the tabs 11 and 13 are respective enlarged pad portions 35 and 37 which serve to hold the flesh and skin back from the incision 29. The pad portions 35 and 37 include apertures 39 spaced along their peripheries for receipt of towel clamps 44 (FIG. 3). The lever arms 15 and 17 bend outwardly as they extend upwardly above the respective pad portions 35 and 37 so they will be spaced apart when installed as shown in FIG. 2, to provide sufficient maneuvering room for the surgeon operating on the bone 31.

Pivotally attached to the upper end of the lever arm 17 is a bail type brace 41 similar to, but longer than, the brace 21 and having its free end 43 engageable with serrations 45 included in the upper extremity of the lever arm 15. Thus, the brace 41 may be utilized as shown in broken lines in FIG. 2 to hold the arms 11 and 13 spaced farther apart than would the brace 21 to thereby maintain the incision 29 farther open.

Referring to FIG. 5, a coupling 47 is formed from sheet material and defines a through passage 49 which receives the free ends 23 and 43 of the respective braces 21 and 41 whereby the arms A and B may be spread apart and such free ends of the braces received in the coupling 47 and butted together to maintain the upper ends of the lever arms 15 and 17 spaced apart even farther than the brace 41.

The arm 51 shown in FIG. 4 is similar to the arm shown in FIG. 1 except that a brace 53 is received within a cutout 55 and is pivotally connected on its upper end to the arm 51 by means of a transverse pivot pin 57.

In operation, the subject retractor may be utilized on a hip or femur and the incision 29 for gaining access to the bone 31 is made and the top portion of the bone 31 stripped, such stripping extending downwardly along the sides 61 and 63 (FIG. 2) as shown in FIG. 2 for receipt of the bone-engaging tabs 11 and 13. The arms A and B are then inserted, the tabs 11 and 13 positioned at the sides 61 and 63 of the bone 31, and the lever arms 15 and 17 grasped to pull the muscles and flesh 67 and 69, on opposite sides of the incision 29, apart. A selected one of the braces 21 or 41 may then be pivoted into locking position with the serrations 25 or 45 in the opposed arm to maintain the incision 29 open to the desired degree. The surgeon can then perform his operation on the bone 31 without the necessity of an assistant holding the arms A and B apart.

Also, the towel clamps 44 may be inserted through the skin and through the apertures 39 to maintain the arms A and B stationary.

The muscle retractor shown in FIGS. 6-9 is similar to that shown in FIG. 1 except that the lever arm 15 is formed in its upper extremity with an upwardly opening slot 75 which receives one end of a rigid brace, generally designated 77, such brace being pivotable supported therein by means of a transverse pivot pin 79 (FIG. 8). The upper extremity of the lever arm 17 is also formed with an upwardly opening slot 81 for receipt of the free end of such brace 77, such free end of the brace 77 being formed with a series of downwardly opening slots 85 for receipt over the lever arm 17 and cooperating to form downwardly projecting teeth 87.

Referring to FIG. 9, a U-shaped locking clasp 91 is formed at its open end with inwardly turned confronting pivot legs 93 which are received in opposite ends of a bore formed in the lever arm 17 to provide for free pivoting of such clasp. The free extremity of the clasp 91 is formed on its opposite sides with transverse inwardly projecting bearing elements 95 which are selectively received in a latching groove 97 formed on the side of the lever arm 17 opposite that to which the clasp 91 is connected.

In operation, the self-retaining muscle retractor shown in FIGS. 6-9 is utilized by inserting the bone-engaging tabs 11 and 13 in an elongated incision 101 to be engaged on opposite sides of the injured bone 103 to separate the muscles therefrom. The upper ends of the lever arms 15 and 17 may then be spread apart the desired distance to spread the muscles away from the injured bone 103 and the free extremity of the brace 77 swung downwardly into the upwardly opening slot 81 to engage the appropriate notch 85 with the lever arm 17 to maintain the arms 15 and 17 in the desired spaced apart relationship. If desirable, the locking clasp 91 may be swung over to the position shown in FIGS. 6 and 7 to lock the brace 77 in its retaining position.

From the foregoing it will be apparent that the selfretaining muscle retractor of present invention provides a convenient means for holding an incision open to gain access to a bone without the necessity of having an assistant present. This is of frequent advantage in outlying areas where assistants and interns are not readily available. Also, the bone need only be stripped on the top side. This decreases the operating time and makes it feasible, if desirable, to shift the retractor longitudinally along the bone during the operation. Further, there are no holding members, such as chains,

which must be extended around under the member in which the incision is made thus eliminating the likelihood of infection and decreasing the amount of body area that must be prepared for surgery.

Various modifications and changes may be made with regard to the foregoing detailed description without departing from the spirit of the invention.

ICLAIM:

1. A self-retaining muscle retractor comprising:

a first rigid, elongated member formed on one extremity with a bone-engaging portion, its other extremity being a first lever arm, said first lever arm including first brace-engaging means and a latch element;

a second rigid, elongated member formed on its one extremity with a bone-engaging portion, its other extremity being a second lever arm including a second brace-engaging means and a second latch element;

a first brace comprising a rigid link pivotally engaged on one end with said first brace-engaging means and engageable on its opposite end with said second latch element;

a second brace comprising a rigid link pivotally engaged on one end with said second brace-engaging means and engageable on its opposite end with said first latch element whereby said respective bone-engaging portions of said first and second members may be inserted into an incision to engage opposite sides of an exposed bone and said other ends of said arms spread apart and said opposite ends of said first and second braces selectively engaged with said respective second and first latch elements to maintain said lever arms spread apart.

2. A self-retaining muscle retractor as set forth in claim 1 wherein:

said first and second arms are each formed with an enlarged pad portion adjacent said bone-engaging portion.

3. A self-retaining muscle retractor as set forth in claim 1 that includes:

a coupling for receiving said opposite ends of said first and second braces to maintain them butted together and said members angled apart at a selected angle.

4. A self-retaining muscle retractor as set forth in claim 1 wherein:

said second brace is longer than said first brace.

5. A self-retaining muscle retractor comprising:

a first rigid, elongated member formed on one extremity with a bone-engaging portion, its other extremity being a first lever arm, said first lever arm including brace-engaging means;

a second rigid, elongated member separate from said first member and formed on one extremity with a bone-engaging portion, its other extremity being a second lever arm;

rigid elongated brace means interposed between said lever arms and engageable on one end with said brace-engaging means and on its opposite end with said second lever arm; and

a latch element for engagement between said opposite end of said brace means and'said second lever arm whereby said respective bone-engaging claim 5 that includes:

a plurality of latching elements spaced along said second lever arm for being selectively engaged by said opposite end of said brace means whereby said brace means may hold said members braced apart at different angles.

7. A self-retaining muscle retractor as set forth in claim 5 wherein:

said first and second members include clamp-receiving apertures therein adjacent said one extremities.

8. A self-retaining muscle retractor as set forth in claim 5 that includes:

means for securing said opposite end of said brace means in engagement with said latching element. 9. A self-retaining muscle retractor as set forth in claim 5 wherein:

said brace engaging means is in the form of pivot means connecting said one extremity of said brace to said first lever arm; and

said latch element is in the form of notch means formed on the free extremity of said brace means.

10. A self-retaining muscle retractor as set forth in 10 claim 9 wherein:

said notch means includes a plurality of notches spaced along said free extremity. 11. A self-retaining muscle retractor as set forth in claim 9 wherein:

said first lever arm is formed with an upwardly opening slot for receipt of said one end of said brace means; and

said pivot means is in the form of a pivot pin projecting across said slot and through said brace means.

12. A selfretaining muscle retractor as set forth in claim 9 that includes:

means for securing said opposite end of said brace means in engagement with said latching element.

l IR i 

1. A self-retaining muscle retractor comprising: a first rigid, elongated member formed on one extremity with a bone-engaging portion, its other extremity being a first lever arm, said first lever arm including first brace-engaging means and a latch element; a second rigid, elongated member formed on its one extremity with a bone-engaging portion, its other extremity being a second lever arm including a second brace-engaging means and a second latch element; a first brace comprising a rigid link pivotally engaged on one end with said first brace-engaging means and engageable on its opposite end with said second latch element; a second brace comprising a rigid link pivotally engaged on one end with said second brace-engaging means and engageable on its opposite end with said first latch element whereby said respective bone-engaging portions of said first and second members may be inserted into an incision to engage opposite sides of an exposed bone and said other ends of said arms spread apart and said opposite ends of said first and second braces selectively engaged with said respective second and first latch elements to maintain said lever arms spread apart.
 2. A self-retaining muscle retractor as set forth in claim 1 wherein: said first and second arms are each formed with an enlarged pad portion adjacent said bone-engaging portion.
 3. A self-retaining muscle retractor as set forth in claim 1 that includes: a coupling for receiving said opposite ends of said first and second braces to maintain them butted together and said members angled apart at a selected angle.
 4. A self-retaining muscle retractor as set forth in claim 1 wherein: said second brace is longer than said first brace.
 5. A self-retaining muscle retractor comprising: a first rigid, elongated member formed on one extremity with a bone-engaging portion, its other extremity being a first lever arm, said first lever arm including brace-engaging means; a second rigid, elongated member separate from said first member and formed on one extremity with a bone-engaging portion, its other extremity being a second lever arm; rigid elongated brace means interposed between said lever arms and engageable on one end with said brace-engaging means and on its opposite end with said second lever arm; and a latch element for engagement between said opposite end of said brace means and said second lever arm whereby said respective bone-engaging portions of said first and second members may be inserted into an incision to engage opposite sides of an exposed bone and, said other ends of said lever arms spread apart, said brace means interposed between said lever arms with said one extremity thereof engaged with said brace-engaging means and said latch element engaging said opposite end with said second lever arm to maintain said lever arms spread apart.
 6. A self-retaining muscle retractor as set forth in claim 5 that includes: a plurality of latching elements spaced along said second lever arm for being selectively engaged by said opposite end of said brace means whereby said brace means may hold said members braced apart at different angles.
 7. A self-retaining muscle retractor as set forth in claim 5 wherein: said first and second members include clamp-receiving apertures therein adjacent said one extremities.
 8. A self-retaining muscle retractor as set forth in claim 5 that includes: means for securing said opposite end of said brace means in engagement with said latching element.
 9. A self-retaining muscle retractor as set forth in claim 5 wherein: said brace engaging means is in the form of pivot means connecting said one extremity of said brace to said first lever arm; and said latch element is in the form of notch means formed on the free extremity of said brace means.
 10. A self-retaining muscle retractor as set forth in claim 9 wherein: said notch means includes a plurality of notches spaced along said free extremity.
 11. A self-retaining muscle retractor as set forth in claim 9 wherein: said first lever arm is formed with an upwardly opening slot for receipt of said one end of said brace means; and said pivot means is in the form of a pivot pin projecting across said slot and through said brace means.
 12. A self-retaining muscle retractor as set forth in claim 9 that includes: means for securing said opposite end of said brace means in engagement with said latching element. 